Prevention & Recovery

3 ways the Canadian health care system needs to improve

Watching the fiery health-care debates south of the border over the past few years, we Canadians may feel a growing urge to proudly wave our flag for all we're doing right. Last March, Candian Living's very own medical columnist, Dr. Danielle Martin, a practicing family physician and vice-president of medical affairs and health system solutions at Women's College Hospital, appeared in front of the U.S. Senate to share lessons gleaned from Canada's single-payer health-care system. The Senate was forced to contemplate the underlying principle that sets our system apart: equity. There's a lot we have to be proud of.

"Health care should be based on need rather than ability to pay," says Dr. Martin. "That's the bedrock of our system." By paying for every citizen, we end up spending just two-thirds of what Americans pay for their limited-access system, per capita. "And we actually provide quite good care," says Dr. Martin, adding that our outcomes for cancer and heart disease are similar or even better than those in the U.S. Plus, as she pointed out to one senator, we don't have 45,000 citizens per year die while waiting for treatment. Not that our system is perfect. There are still ways to make it more equitable.

1. Improve coverage of medications.
Back in the '50s and '60s, when Medicare was in its infancy, most health care was delivered in hospitals, which meant that prescription drugs weren't a significant cost for most people. "Times have really changed," says Dr. Martin. "Many Canadians are living a long time with chronic medical conditions now, and they need to take medications long-term." In the past 50 years, drug costs have become quite a concern. In fact, a 2012 study found that one in 10 Canadians struggles to pay for medication, and many fail to fill prescriptions or take them as often as directed.

2. Deliver consistent access.
"There's a role for the federal government to play in ensuring that Canadians can count on access to similar services, no matter where they live," says Dr. Martin. In March, Canada's Health Care Accord, which united all of the provinces and territories under common goals, expired. There's a huge variation in coverage between provinces, and Dr. Martin says we need national leadership to ensure consistent care.

3. Ensure that every Canadian has access to high-quality primary care.
"No Canadian should be without a family doctor, and no Canadian should have to wait six weeks for an appointment with one," says Dr. Martin. Currently, where you live impacts your access to primary care. "It's not so much about the number of doctors, it's about the distribution—where they're practicing, and how many are choosing primary care over specialties." To solve the problem, Dr. Martin says we need bigger teams of doctors, nurses and other health-care providers, rather than individual practices. "It's about being linked in â€¨to a bigger system."

For more advice from Dr. Danielle Martin, read what she has to say about these 3 aging myths.

This story was originally titled "Care That's Fair in the July 2014 issue.